Der Unfallchirurg
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Manubriosternal dislocation caused by indirect flexion-compression trauma is an extremely rare condition. Two forms of manubriosternal luxation are distinguished: in type I the sternum is dislocated posterior and in type II anterior to the manubrium. Direct or indirect trauma may cause manubriosternal dislocation. ⋯ In the literature only a few case-reports of patients undergoing operative therapy are published. We report a type II dislocation of the manubriosternal joint caused by indirect flexion-compression trauma. We achieved a very good long-term result using a 8-hole 1/3 tubular plate for fixation of the manubriosternal joint after reposition.
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We report a rare case of recurrent atraumatic posterior-inferior dislocation of the shoulder in an eight year old girl. After closed reduction of the locked dislocation and conservative treatment three further dislocations occurred. ⋯ Within a clinical followup of 24 months the shoulder remained stable without loss of function but atraumatic posterior-inferior dislocation of the contralateral shoulder occured. The bilateral involvement indicates a predisposing factor, predominantly gross capsular laxity, of this rare form of instability.
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Comparative Study
[Diagnosis of intra-articular fracture of the head of the tibia. A prospective comparative study].
Complete visualization of the joint surface is essential for correct assessment of tibial head fractures. Conventional tomography, computed tomography (CT), and magnetic resonance imaging (MRI) are compared in this prospective study. We examined 27 patients (19 suffering from B fractures and 8 from C fractures) from 1 January 1995 to 11 November 1998. ⋯ Local hospital conditions permitting, X-ray-loaded conventional tomography should no longer be used in tibial head fractures. X-ray-free MRI is most efficient in cases of B fractures, which can in most cases be treated with a minimum of invasive techniques. Computed tomography is to be used in cases of C fractures that are regularly managed by open surgery accompanied by direct visualization of the inside of the knee joint.
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Comparative Study
[Intracompartmental pressure measurement in in acute compartment syndrome. Results of a survey of indications, measuring technique and critical pressure value].
The early diagnosis of acute compartment syndrome is very important, compartment monitoring is advocated. There is however still some controversy regarding the use of compartment pressure measurement devices in the diagnosis of acute compartment syndrome. We present the results of a survey that was designed to explore this issue in Germany. ⋯ The remaining 48.6% (n = 104) include haemodynamic parameters in their decision. The surgeons employ widely differing methods of approach in the diagnosis of acute compartment syndrome. Some of these are extremely different from the methods recommended in the literature.
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Case Reports
[Perthes syndrome. The classical symptom triad as a rarity in trauma surgery practice].
Perthes syndrome or traumatic asphyxia is a condition characterised by subconjunctival hemorrhage, cervicofacial petechiae and cyanosis caused by severe compression of the chest. Diagnosis is made by history and clinical examination. Associated injuries such as intrathoracic or abdominal lesions can be life-threatening and must be strictly assessed. This report demonstrates an illustrative case of this rare injury.